Patterns of red blood cell utilization: Harnessing electronic health records data from the Information Standard for Blood and Transplant (ISBT) 128 system within the Biologics Effectiveness and Safety (BEST) initiative

Author:

Obidi Joyce1ORCID,Sridhar Gayathri2,Dores Graça M.1ORCID,Whitaker Barbee1ORCID,Villa Carlos H.1,Storch Emily1ORCID,Chada Kinnera1,Schilling Lisa M.3,Natarajan Karthik4,Biondich Paul5,Soares Andrey3,Spotnitz Matthew4,Falconer Thomas4,Purkayastha Saptarshi5ORCID,Draper Nicole L.6,Wong Hui‐Lee1,Stagg Matthew2,Reich Christian2,Anderson Steven1,Shoaibi Azadeh1

Affiliation:

1. U.S. Food and Drug Administration Silver Spring Maryland USA

2. IQVIA Inc Falls Church Virginia USA

3. Data Science to Patient Value Program and Adult and Child Consortium for Outcomes Research and Delivery Science University of Colorado Anschutz Medical Campus Aurora Colorado USA

4. Columbia University Medical Center New York New York USA

5. Regenstrief Institute Indianapolis Indiana USA

6. Department of Pathology University of Colorado Anschutz Medical Campus Aurora Colorado USA

Abstract

AbstractBackgroundCurrent hemovigilance methods generally rely on survey data or administrative claims data utilizing billing and revenue codes, each of which has limitations. We used electronic health records (EHR) linked to blood bank data to comprehensively characterize red blood cell (RBC) utilization patterns and trends in three healthcare systems participating in the U.S. Food and Drug Administration Center for Biologics Evaluation and Research Biologics Effectiveness and Safety (BEST) initiative.MethodsWe used Information Standard for Blood and Transplant (ISBT) 128 codes linked to EHR from three healthcare systems data sources to identify and quantify RBC‐transfused individuals, RBC transfusion episodes, transfused RBC units, and processing methods per year during 2012–2018.ResultsThere were 577,822 RBC units transfused among 112,705 patients comprising 345,373 transfusion episodes between 2012 and 2018. Utilization in terms of RBC units and patients increased slightly in one and decreased slightly in the other two healthcare facilities. About 90% of RBC‐transfused patients had 1 (~46%) or 2–5 (~42%)transfusion episodes in 2018. Among the small proportion of patients with ≥12 transfusion episodes per year, approximately 60% of episodes included only one RBC unit. All facilities used leukocyte‐reduced RBCs during the study period whereas irradiated RBC utilization patterns differed across facilities.DiscussionISBT 128 codes and EHRs were used to observe patterns of RBC transfusion and modification methods at the unit level and patient level in three healthcare systems participating in the BEST initiative. This study shows that the ISBT 128 coding system in an EHR environment provides a feasible source for hemovigilance activities.

Funder

U.S. Food and Drug Administration

Publisher

Wiley

Reference15 articles.

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2. NHLBI.Blood transfusion [Monograph on the Internet].2020Available from:https://www.nhlbi.nih.gov/health-topics/blood-transfusion

3. American Red Cross.Blood needs and blood supply [Monograph on the Internet].2020Available from:https://www.redcrossblood.org/donate‐blood/how‐to‐donate/how‐blood‐donations‐help/blood‐needs‐blood‐supply.html

4. Red Blood Cell Transfusion: A Clinical Practice Guideline From the AABB*

5. Quality of clinical practice guidelines about red blood cell transfusion

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